The present invention is a system and method for automatically controlling the selection and display of visual information to assist a user in testing and/or arriving at diagnostic hypotheses. One embodiment of the invention may be employed as a visual medical browser, and is more particularly referred to herein as a visual diagnostic system (VisualDx™). The VisualDx system is intended for use in patient treatment or care settings to assist users in identifying possible diagnoses based upon a set or constellation of patient findings.
Although portions of the following description will focus on a particular dermatological application for aspects of the invention (Adult Dermatology), it should be further appreciated, that various alternative applications for the underlying system and components are possible. One such alternative application is a system (e.g., emergency medicine) that assists in the identification of pills or other oral medications that a patient might present during treatment. A similar pill-identification application could be one where law enforcement technicians use the system as a first line of identifying narcotics or other oral medications seized during an arrest or investigation.
The present invention is intended to be an improvement to paper-based atlases that doctors consult when investigating possible diagnoses. Similar, visual and textual information is presented to users using a computer-driven interface that not only speeds access to the information, but can also assist the user in the diagnostic process by focusing on relevant categories or constellations of findings most indicative of the diagnoses. The system is believed to be distinguishable from other medical diagnostic system that simply seek a set of symptoms and input the symptoms to an artificial-intelligence engine to create a ranked (by probability) list of diagnoses. To the contrary, the present invention uses categories or constellations of patient findings, or sample characteristics, to provide a combination of textual and graphic/image information to the user, so that the user may test or review a plurality of possible diagnoses without being “lead” to one diagnosis over another. In other words, the present system provides a source of knowledge (medical or other), in multiple forms, that allow users to test diagnostic hypotheses against an image database using patient findings or sample characteristics.
In the visually centered medical specialties (e.g., dermatology, radiology, ophthalmology, pathology) physicians hone their ability to classify, correctly identify, and relate the visual features of disease to a knowledge base of diagnostic features, criteria etc. Accordingly, an objective of the instant invention is a software-based schema or strategy to assist less experienced medical users in the interpretation of visual clues (presentations and/or findings) as they relate to diagnostic hypotheses. Both graphical representations, drawings and refined picture icons (PICONS) are used to augment the medical keywords in the software database.
One purpose of the present invention is to provide near instantaneous access to diagnostically relevant images at the place where they may be used—for example when interviewing a patient. The present system relies upon a combinatorial, non-expert system approach to diagnosis or identification along with access to related images. Images, whether found under a microscope, on a radiological view box or a computer monitor, are often signs or indicators for diagnoses and diseases. Users of medical diagnostic aspects of the present invention are intended to be health-care personnel who need real-time access to data at the point of patient care (e.g., outpatient offices, emergency departments, walk-in clinics, hospitals, military medical facilities, occupational clinics, long-term care facilities, and telemedicine departments). However, the invention may also be used in educational or reference-based environments.
The present invention, to a significant degree, builds upon an innate human ability to match patterns. This is the basis for any pictorial handbook or guide, such as in field guides for plants, birds, animals and atlases in medicine. Moreover, all visual identification problems benefit from user experience and knowledge. When prior visual knowledge is limited, picture or image “centered” reference materials can assist the inexperienced. Paper based, pictorial references have a linear structure and do not allow for user-defined groupings and matching of pictures. Software based image systems offer the possibility of combinatorial searching as well as user-defined comparison of possibilities.
The visual diagnostic embodiment of the present invention, VisualDx, assembles textual and visual knowledge, thereby creating the ability to “presort” and display images so that a user can more effectively engage in pattern matching. These unique functional, organizational and graphical display capabilities are useful within any professional area where an individual has to make a visual “diagnosis” or identification, or recognize a visual feature.
It is believed that aspects of the present invention have particular relevance within traditional medicine and healthcare industries, including but not limited to:                Dermatology        Dermatopathology        Ophthalmology        Dentistry        Pathology including all subspecialties, Hematology, renal, neuropathology, etc.        Obstetrics/Gynecology        Otolaryngology        Gastreneterology (Endoscopic images)        Surgery (intraoperative images)        Urology (Endoscopic images)        Pulmonary Medicine (Endoscopic images)        Microbiology (cultures, microscopic slides, e.g. gram stains)        Oral Medicine        Patient self-use (diagnose your own rash or child's diaper rash)        
In accordance with the present invention, there is provided a system to aid in a visual diagnostic process, comprising: an image database; a knowledge database, cross-referenced to said image database, for the purpose of assisting in the diagnostic process; a user-interface to solicit, from a user, a plurality of descriptive characteristics of a sample requiring diagnoses; a diagnostic engine, responsive to said characteristics, wherein said characteristics of the sample are employed by said engine to identify, from a plurality of possible diagnoses, a subset of diagnoses that are consistent with the characteristics; and using the subset of diagnoses, reorganizing an information space of said image database for concurrent presentation of a plurality of images for user review via the user-interface.
In accordance with another aspect of the present invention, there is provided a method for aiding a visual diagnostic process, including the steps of: creating an image database from a collection of images pertaining to a particular subject matter; creating a knowledge database with other data related to the particular subject matter, wherein said knowledge database is cross-referenced to said image database, for the purpose of assisting in the diagnostic process; collecting from a user, through a user-interface adapted to the particular subject matter, a plurality of descriptive characteristics of a sample requiring diagnoses; in response to said descriptive characteristics, identifying, from a plurality of possible diagnoses included within the knowledge database, a subset of diagnoses consistent with the descriptive characteristics collected from the user; and using the subset of diagnoses, reorganizing an information space of said image database for concurrent presentation of a plurality of images related to the descriptive characteristics for user review via the user-interface.
One aspect of the invention is based on the discovery that general and primary care physicians are often ill-informed or lack sufficient tools and resources to investigate a plurality or alternative diagnostic hypotheses. This discovery addresses problems that arise in traditional patient diagnostic situations, where a medical practitioner is faced with first identifying a set of possible diagnoses based on symptomatic and other patient findings, and then working to select at least one particular diagnosis for treatment.
This aspect is further based on the discovery of techniques that can appropriately match relevant visual information to unique characteristics of the individual patient presentation or sample being analyzed. A purpose of the various embodiments of the present invention is to provide near instantaneous access to relevant images at or near the place of use of such information. For example, identification of a street drug would be useful to both police investigators at a crime scene or crime lab, as well as to emergency room personnel. Similarly, coroners may be able to employ the present system in assisting with a determination of the cause of death, perhaps even in close proximity to an examination area, where comparisons of actual specimens/samples could be made to the images cataloged in the system. The present system uses a combinatorial, non-expert approach for identification/diagnosis and access to images. Visual characteristics or clues, wherever found, are often signs or indicators for identification and/or diagnosis. Time-critical access to relevant visual clues can be achieved when related findings or characteristics are correlated to profiles, then images are preferably displayed as “stacks” or “clusters” within the context of the inputted findings or characteristics. The display of relevant images in relation to various diagnoses, or as a stack of images related to a particular diagnosis, allows a practitioner to visually compare and contrast the images with their own observations of the patient, thereby improving the likelihood of an accurate and timely diagnosis.
The objectives of the present invention include: the creation of a streamlined process for acquiring and tracking images to assist in diagnosis and identification; to reference all items in a knowledge base to the associated descriptive literature; to implement a user-friendly, efficient and network distributed data entry/access system; to capitalize on network connectivity for integrating knowledge sources; to publish images on transportable media and over network connections for public and private use; to create focused subset modules of the knowledge base to serve critical areas of need for identification and diagnostic information (e.g. adult dermatology, fever and rash, pill identification, plant identification, etc.).
An aspect of the invention is based on the fact that professionals lack sufficient tools and resources to investigate a plurality of alternatives when seeking to identify a specimen or verify a diagnostic hypothesis. This discovery addresses problems that arise in traditional situations, where a professional (doctor, nurse-practitioner, coroner, police investigator, etc.) is faced with first reducing the set of possible identifications or diagnoses to a number with which the professional can work based upon a set of predetermined characteristics and findings, and then working to complete the identification or diagnosis.
One aspect of the present invention is generally referred to as a visual browser and the system is intended for use as a tool to assist in the identification of particular traits or common visual manifestations and their association with data in particular fields of investigation (e.g., medicine, drug enforcement, etc.). The various embodiments of the present invention are intended to be improvements over paper-based atlases and incomplete or non-existent databases that doctors and other professionals consult when attempting to identify a physical element or investigating hypotheses (e.g., diagnoses). Throughout all of the various embodiments, similar, visual and textual information is presented to users using a computer-driven interface that speeds access to the information, and can also assist in the diagnostic/identification process by focusing a user on relevant characteristic categories or constellations of findings having a likelihood of leading to a conclusion (e.g., identification, confirming a diagnoses, estimation of damage, etc.).
The techniques described herein are advantageous because they can be adapted to any of a number of diagnostic situations, where a practitioner/user is faced with making a diagnosis, or similarly testing a plurality of diagnostic hypotheses. As a result of the invention a practitioner faced with such a situation is aided by image/graphic and textual tools that allow them to consider a range of possible diagnoses and to review details of each.
The present invention will be described in connection with a preferred embodiment, however, it will be understood that there is no intent to limit the invention to the embodiment described. On the contrary, the intent is to cover all alternatives, modifications, and equivalents as may be included within the spirit and scope of the invention as defined by the appended claims.